I Smoked 2 Ciggerettes and Had 2 Beers 9 Days After Surgery. Am I in Trouble?

You can cause damage to your incompletely-healed tummy skin or umbilicus with even 1 cigarette or even inhaling second-hand smoke! If the skin didn't die you were just plain lucky, because this can happen even in patients who use NO tobacco or nicotine products, though it is rare. In a smoker (yes, even 1 cigarette), the risk of skin death rises to as high as 15-20%. Not an exaggeration!

Just because you drove fast without a seat belt and didn't kill yourself doesn't make it right. And it certainly isn't very smart. So, with all due respect, disregarding your surgeon's advice and smoking and drinking IS just plain stupid. Did someone else pay for your operation? Because if you did so yourself, this is taking an unnecessary chance of ruining your results and wasting your investment in yourself, when there are plenty enough reasons OUTSIDE your and your surgeon's control for problems or complications to occur. Why increase those risks?

Disrespectful is what this is to your surgeon, who came to your operation fully trained, prepared, and exerted all his or her efforts to give you the best result possible. Then you disregard advice and recommendations and go on-line and hope for absolution?

Sorry, but there are already too many patients who expect their doctor to be "perfect" but complain about how much good medical or surgical care costs, and then don't even care enough to follow directions.

To those who feel I'm being too harsh, I apologize. But patients who intentionally disregard good advice deserve no sympathy!   The attitude that "It's my money and my body" becomes meaningless when the patient's dead skin needs surgical debridement, dressings, and reconstructive surgery, and the patient then needs someone to "fix it." Usually for free, and usually with the statement that "I wasn't told that--if I had known it would be so serious, then I wouldn't have smoked and drank!"

Please use this as a learning experience and hope and pray you don't develop dead skin, dead belly button, or wound breakdown. And let your surgeon know so further advice can be given. Good luck.

Hello! Thank you for your question! The issue with nicotine is that it
also acts as a vasoconstrictor, clamping down of blood vessels. Blood
supply is always of great concern during any surgical procedure, but
especially in such a procedure as a breast augmentation where the viability of the
skin/tissue, and nipple-areolar complex is obviously important. Since the vascularity to
the area is already tenuous since it will be raised by cutting around
the area, maximizing blood flow to the tissue is critical. Typically,

we recommend at least 6 weeks of smoking cessation prior to and at
least 6 weeks after any surgical procedure. The longer, the better.
Nicotine always increases the risk for infection, nipple necrosis, poor
scarring, and
wound complications, as well as other health consequences including blood clots. The
anesthesia risk is greater with general anesthesia as well as pulmonary
issues/lung infections postoperatively. I would
discuss this with your surgeon prior to your procedure. Hope that this
helps! Best wishes!

Each surgeon has different guidelines for postoperative care. Consult with your surgeon as he or she knows the specifics about you and the scope of the surgery.

Dear bobby,You are probably fine.  Here are the major points of smoking Tobacco or Marijuana before or after surgery:1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. This is especially bad in breast reductions or face lifts. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk. Your skin and tissue can turn black and fall off if this happens. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke. Hookah also does not decrease nicotine.2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.Best wishes,Pablo Prichard, MD

Hi,

  If you are not in trouble with a loss of tissue at 9 days, then you are probably able to get away with the small amount of smoking but cigarette or any other form of nicotine products are definitely a no no for tummy tuck patients. 

  Smoking constricts the vessels trying to heal the redraped tissue and since it is comprimised by the dissection under the flap, it already is challanged for a sufficient blood supply to have it survive.  Why challange it?  You saw in your consent forms that smoking is bad.  Follow the directions and get through this.

  When you get your ps permission, then you can smoke all you want although your body will suffer from the effects.  Be smart with all of this...consider this the beginning of your new body confidence and perhaps you can take it a step further and quit the smoking.

 

No, it wasn't a good idea to drink those beers and especially to smoke those cigarettes in the immediate postopo period. Smoking and the effects of nicotine can negatively influence wound healing so, if your scar isn't to your liking, I'm sorry to say that you will assume the responsibility for it. I emphasize the negative effects of smoking in the prep consultation and hope that patients who spend significant amounts of money on cosmetic surgery will not undermine the result by smoking. Please share this admission with your surgeon and seek referral to a smoking cessation program. It will help your healing in the short run and can save your life longterm.

It was definitely not a wise decision to smoke so soon after your surgery - and drink alcohol as well. You should follow the instructions of your surgeon to help minimize postoperative complications and not compromise the healing process. Smoking can impair healing resulting in loss (death) of some tissue. Even 2 cigarettes can do this ... so be more prudent!

Hello,

Smoking after surgery can have a negative effect on healing.  I would refrain from additinoal smoking as well as drinking alcohol.  Stay well hydrated and follow your surgeons instructions.

All the best,

Dr Repta

Thank you for the unusual question.

No I do not think you have caused any harm with 2 cigarettes and a few beers. However, I would suggest you abstain from nicotine products for at least another month (preferably forever). I would suggest compliance with your plastic surgeon's  recommendations in general.

I hope this helps.

Most likely you'll be fine - but it's not a good idea.  And you should touch base with your plastic surgeon, just to be sure.

Smoking tobacco (in fact, any use of tobacco products) is, of course, dangerous from many standpoints, and certainly with respect to plastic surgery including tummy tucks.  This has to do with the harmful effects of tobacco on the blood flow to the flap, which is critical for healing.  Use of tobacco in this manner significantly increases wound healing complications with plastic surgery.

The alcohol is probably less of a concern (and 2 beers 9 days after surgery is better than 9 beers 2 days after surgery....) but - still - unwise.

My advice:  follow your plastic surgeon's instructions explicitly and particularly with respect to tobacco, and give your body a chance to heal without additional impediments.

I hope that this helps, and good luck,

Dr. E